自由体位分娩对产妇产痛、分娩控制感、母婴结局及盆底肌功能的影响  

The influence of free position delivery on maternal labor pain,labor control,maternal and infant outcomes and pelvic floor muscle function

作　　者：杨胜晗[1] 王倩[1] 田玲[1] Yang Shenghan;Wang Qian;Tian Ling(Department of Obstetrics and Gynecology,the Third People′s Hospital of Bengbu,Anhui Bengbu 233030,China)

机构地区：[1]安徽省蚌埠市第三人民医院妇产科,233030

出　　处：《中国医师进修杂志》2021年第2期168-174,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析自由体位分娩对产妇产痛、分娩控制感、母婴结局及盆底肌功能的影响。方法选取2018年4—12月安徽省蚌埠市第三人民医院采用自由体位分娩的48例产妇作为研究组,按1∶1选取同期采用坐式分娩的48例产妇作为对照组,比较两组产妇妊娠结局,观察两组产程时间,统计出血量;采用简化McGill疼痛问卷(SF-MPQ)、分娩控制量表(LAS)评价产妇分娩2 h后疼痛及分娩控制感;采用新生儿Apgar评分对新生儿窒息情况进行评定;采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评价两组产妇分娩后6周的焦虑、抑郁状态;比较两组产妇产后6周盆底肌功能,并统计两组不良分娩结局的发生情况。结果研究组产妇中转剖宫产率低于对照组[4.17%(2/48)比16.67%(8/48)],差异有统计学意义(χ2=4.019,P=0.045)。研究组第一、二产程时间、总产程时间及出血量均低于对照组[(472.69±55.24)min比(515.25±67.26)min、(43.26±5.23)min比(52.34±5.56)min、(535.24±38.22)min比(582.68±40.16)min、(179.12±25.65)ml比(195.34±24.31)ml],差异有统计学意义(P<0.05);两组第三产程时间比较差异无统计学意义(P>0.05)。研究组产妇分娩后2 h疼痛视觉模拟量表(VAS)、言语反应量表(VRS)、现实疼痛强度量表(PPI)、HAMA、HAMD评分低于对照组[(6.24±1.21)分比(7.68±1.32)分、(21.25±2.98)分比(27.95±3.75)分、(2.78±0.29)分比(3.49±0.85)分、(6.35±0.18)分比(7.54±0.16)分、(4.38±0.12)分比(5.54±0.25)分],LAS评分高于对照组[(175.18±15.64)分比(122.65±14.85)分],差异均有统计学意义(P<0.05)。研究组分娩1、5 min新生儿Apgar评分高于对照组,但差异无统计学意义(P>0.05)。两组盆底肌肌力异常、肌力疲劳度及阴道压力异常情况比较差异无统计学意义(P>0.05)。研究组不良分娩结局总发生率低于对照组[13.04%(6/46)比35.00%(14/40)],差异有统计学意义(P<0.05)。结论自由体位分娩可降低中转剖宫产�Objective To investigate the influence of free position delivery on maternal labor pain,labor control,maternal and infant outcomes and pelvic floor muscle function.Methods Forty-eight pregnant women who took delivery in free position in the Third People′s Hospital of Bengbu from April to December 2018 were selected as the study group,and 48 pregnant women who took sitting position delivery at the same period were selected as the control group at a 1∶1 ratio.The pregnancy outcomes of the two groups were compared.The duration of labor time and the amount of bleeding were observed.Simplified McGill Pain Questionnaire(SF-MPQ)and labor agentry cale(LAS)were used to evaluate the pain and the labor control of mothers 2 h after delivery.The neonatal asphyxia was evaluated by neonatal Apgar score.The Hamilton anxiety scale(HAMA)and the Hamilton depression scale(HAMD)were used to evaluate the anxiety and depression status of mothers in the two groups 6 weeks after the delivery.The pelvic floor muscle function of the pregnant women in the two groups was compared 6 weeks after the delivery.Results The rate of maternal transfer to cesarean section in the study group was lower than that in the control group[4.17%(2/48)vs.16.67%(8/48)],and the difference was statistically significant(χ2=4.019,P=0.045).The time of the first and the second stage of labor,the total duration of labor,and the amount of bleeding in the study group were lower than those in the control group[(472.69±55.24)min vs.(515.25±67.26)min,(43.26±5.23)min vs.(52.34±5.56)min,(535.24±38.22)min vs.(582.68±40.16)min,(179.12±25.65)ml vs.(195.34±24.31)ml],and the differences were statistically significant(P<0.05).There was no statistically significant difference in the time of the third stage of labor between the two groups(P>0.05).After the delivery,the scores of verbal response scale(VRS),visual analogue scale(VAS),present pain intensity scale(PPI)and HAMA,HAMD in the study group were lower than those of the control group[(6.24±1.21)scores vs.(7.68±1.

关 键 词：分娩 体位 分娩过程 分娩疼痛 分娩并发症 

分 类 号：R714.3[医药卫生—妇产科学]